Partial splenic embolization in a cirrhotic patient with thrombocytopenia and a traumatic brain injury: a nontraditional application of an established treatment modality.

摘要

Splenic embolization was first performed on a human patient by Maddison in 1973 when an autologous clot was successfully used to embolize the splenic artery of a patient with recurrent hemorrhagic esopha-geal varices. Since that time, splenic embolization and partial splenic embolization (PSE) have been used sporadically to manage the complications of portal hypertension, including bleeding varices and hyper-splenism. However, large-scale application of PSE was limited by an unacceptably high complication rate. PSE has gained widespread acceptance in the trauma population as an adjunct to nonoperative management of splenic injuries with active bleeding. Complications remain a concern. Other reported applications of PSE include: improvement of hematologic parameters in patients with cancer undergoing chemotherapy, improvement of hematologic parameters in patients with hepatitis C undergoing antiviral combination therapy, and preoperative intervention to avoid blood transfusion in patients with immune thrombocytopenic purpura before formal splenectomy.